Spine Surgery
About the Spine
Your spine, or spinal column, consists of 33 stacked vertebrae (bones) woven together with joints, tendons, ligaments, nerves and muscles. It needs to be strong because it is your body’s main support, and it needs to be flexible to allow you to stand upright, to bend and to twist.
The vertebrae are separated by intervertebral disks which provide the cushioning and absorb the impact of movement.
Your spine has three levels, or regions:
the cervical spine, or neck, which lies at the top of your spine, connecting to your skull;
the thoracic spine, from the base of the neck to your abdomen;
the lumbar spine, also known as the lower back.
Any one of these regions can be injured or strained, or affected by disease.
What spine conditions does Dr Ambikaipalan treat?
Dr Ambikaipalan treats a number of spine conditions including:
Spine Trauma, which is damage to the spine or spinal cord caused by sudden injury. The most common causes are car accidents, falls and sporting injuries, but spine trauma can also occur while you perform day-to-day activities such as lifting heavy objects. Spine trauma includes fractures, dislocation, herniated disc, and ligament tears.
Spinal Deformity refers to deviation of the natural curvature of the spine. While the spine appears straight from the front, a side-view reveals two gentle curves. The spine provides stability by holding the body up, and the curvature allows for weight distribution and flexibility of movement.
There are three main types of spinal deformity:
- Lordosis of the lumbar spine, or ‘swayback’, where the lower back curves inward rather than outward;
- Kyphosis of the thoracic spine, where the upper back bends forward, often forming of a hump;
- Scoliosis, where there is a sideways curvature of the spine.
Spine Degeneration, most commonly found in older adults. As you age the discs between the vertebrae begin to wear away, most often in the areas of the spine that involve the most movement; cervical spine (neck) and the lumbar spine (lower back). This impacts on the normal structure on the spine and its function.
Infection of the spine is rare but serious. The most common type is vertebral osteomyelitis, which is caused by bacteria and can develop after spine trauma or after surgery. Immediate treatment includes antibiotics and analgesics for pain relief.
Spinal tumours can be either primary or secondary. Primary tumours develop within the spinal column and are generally benign. Secondary tumours are the most common type, and have spread from cancer in another part of the body. They typically grow and spread quickly.
Why would I need spinal surgery?
The spine is important for movement, providing you with mobility and flexibility. Spinal surgery is most often performed to stabilise a spine that is unstable, or when there is persistent pain that has not been resolved by more conservative treatments.
Surgery may be indicated in cases of:
disc problems that persist
degenerative scoliosis
a broken vertebra
infection of the spine
bone spurs, often caused by arthritis
spinal stenosis (narrowing of the spinal canal)
overgrowth of bone
spinal tumour
What is involved in spinal surgery?
Discectomy where the damaged or herniated part of the intervertebral disc, which separate the vertebrae and is responsible for cushioning, is removed. This is done to relieve pressure on nerves.
Laminectomy where the lamina (a part of the verterbrae) is removed in order to create more space around the spinal cord and relieve compression and any nerve pressure.
Spinal fusion where two or more bones in your spine are permanently fused, eliminating space and mobility between them. This provides stability, preventing them from moving, and any is often done to eliminate pain due to degenerated or injured intervertebral discs.
Artificial disc replacement where the damaged or worn out intervertebral disc is removed and replaced with an artificial disc. This is an alternative to spinal fusion and is done to relieve pain while also allowing for mobility.
Where will my surgery take place?
Your surgery will be performed by Dr Ambikaipalan under general anaesthetic at the Royal Melbourne Hospital or the Epworth Hospital Richmond.
What will my recovery be like following spinal surgery?
All spinal surgery is considered major surgery, and recovery time will depend on the procedure. While you may recover from a discectomy after six to eight weeks, you may need three months to recover after a laminectomy.
Dr Ambikaipalan will advise you on pain management, wound care, and rehabilitation. Rehabilitation will be important for your recovery. Physical therapy will begin while you are still in hospital and will most likely include care by a physiotherapist, who will instruct you on daily exercises to regain strength and mobility. The best exercise after most spinal surgery is gentle walking.
What are the risks of spinal surgery?
Any surgery comes with potential risks, and all spinal surgery is major surgery, particularly because the spinal column encases a rich network of nerves.
Dr Ambikaipalan will discuss any potential risks with you at your consultation.